Why Joints Ache

In his younger days, Dave Wandling played baseball, slow-pitch softball and golf.

“I went at it full force until about age 55,” said the retired VP of sales and marketing. “Playing catcher meant I did a lot of squatting and bending my knees.”

Wandling described himself as a large-framed man who has been active most of his life, whether playing sports or doing yard work.

“As I got older, I noticed more and more pain in my knee. I tried the over-the-counter pain relievers until it was beyond the point that they were helping. I also had cortisone shots and those would help for two to three months.”

But as time progressed, so did ongoing pain. He had trouble walking down steps. Then, his other knee also began hurting.

He knew he ultimately needed to seek input from an orthopedic specialist.

PAIN AND SWELLING.

Wandling, now 66 years old, saw James Burke, MD, an orthopedic surgeon on staff at Missouri Baptist Medical Center, who diagnosed osteoarthritis.

According to Dr. Burke, “Osteoarthritis can be aggravated by injury or overuse. It is the most common type of arthritis and it becomes more common as we age.”

An inflammatory condition, osteoarthritis is caused by the cartilage, which cushions our joints, wearing away. If the normal, smooth cartilage has worn out, pain and swelling generally result.

“Cartilage cannot be renewed or replaced. You cannot grow new cartilage,” said Dr. Burke. “So, low impact activities are good to help keep your range of motion, while preventing further breakdown of cartilage.”

SURGERY BECAME BEST OPTION.

“I kept putting off surgery because I had to be on my feet a lot at tradeshows,” said Wandling.

But after dealing with the pain for four to five years, Wandling decided his knees had come to the point where surgery was the best option to alleviate pain.

“Dr. Burke also advised I do it ‘now’ while I was healthy rather than wait until I got older when the risks of surgery might increase for me,” he said, explaining that he has high blood pressure.

So, almost four years ago, Wandling opted to have knee replacement surgery on both knees – at the same time. This would save him from having to go through two surgeries and two estimated eight-week recovery periods. He knew his progress might be slower with two knees to rehabilitate simultaneously.

“I made the right choice to have surgery,” he said.

Within three weeks, Wandling was driving and back to work almost full time. Two months after surgery, he planned a trip to his condo at the lake. He set a goal to walk the 29 steps to the condo.

“I not only did that, but I walked it three to four times actually carrying things, too. Then, I walked down the 99 steps from the condo to the boat dock, and I was pain-free doing it.”

Today, Wandling, who believes it’s important to stay limber, continues to do yard work. He also uses his gym membership at least three times a week, walking about 45 minutes on a treadmill and riding an exercise bike. Surgery also enabled him to keep up with his two grandchildren, ages 6 and 11.

OSTEOARTHRITIS: WHO IS AT RISK?

How do you avoid osteoarthritis? In some cases, you can’t. Although the risk of osteoarthritis is multi-factorial, genetics plays a huge role.

“In fact, it would be number one,” said Dr. Burke.

“If someone has a family history of arthritis, then they have a very strong chance of having arthritis, too. Weight is probably second.”

“Being overweight puts an ‘astronomical load’ on the joints over time,” said Dr. Burke, explaining that the increased force on the joints is multiplied several fold. “Even modest amounts of weight loss can make a huge difference on joints! Also, joint replacements on the morbidly obese do not last as long.”

Following genetics and weight are an individual’s activity level and any prior injuries.

And, how does this orthopedic surgeon stay in shape? Dr. Burke, who is married with one son and one daughter, claimed his primary exercise is refereeing and coaching his middle and high school age children’s soccer and baseball teams.

“I get exercise chasing after the kids, and have less time to eat and more time on my feet.”

“I became an orthopedic surgeon because it is one of the few areas in medicine where you can lay your hands on someone, such as fixing broken bones and doing joint replacements, and afford almost immediate improvement in their well-being.”

OTHER POINTERS.

On load and motion:

To maintain the cartilage we have, it is best to have motion with little load or weight placed on the joints. Maintaining one’s range of motion is healthy for cartilage and can reduce stiffness of the joints.

Dr. Burke said, “Creaking sounds in the joints are just natural wear and tear. The clue to when to stop an activity is if there also is pain and/or swelling.”

Over-the-counter options:

Ibuprofen or Naproxen can help, but Dr. Burke advises to use them only for short periods of time and if they help. He does not recommend them for people with chronic conditions, such as hypertension or heart disease, who are also on other medications, as they can interfere with other drugs.

Joint supplements, such as glucosamine and chondroitin, also are available over-the-counter, but Dr. Burke said, “Data for glucosamine and chondroitin is all over the board. If you look at the data, most of the experts in joint replacement find the results wishy-washy. It is not dangerous to try. I suggest someone try it for two months and if they do not see that it helps them, then don’t waste money on it.”

According to Dr. Burke, topical creams, such as muscle relief creams, work for muscle pain. They offer no appreciable benefit to the joints.

Cortisone shots can offer pain relief and decrease inflammation in the joint. “The value depends on the patient’s response. If the cortisone is only effective for a short time, then we may be looking at surgery,” he said.

James S. Burke, Jr., MD, is a board-certified orthopedic surgeon on staff at Missouri Baptist Medical Center. He received his medical degree from the University of Missouri-Kansas City. He completed his internship at Loyola University of Chicago and residency at St. Louis University School of Medicine.

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